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Topamax is an anticonvulsant medication used to treat seizures in children and adults. This medication may also be used to treat and prevent migraine headaches.

Topiramate is a second-generation antiepileptic drug that blocks voltage-gated sodium channels which helps reduce membrane depolarization. This action helps prevent and reduce the severity of seizures. Topamax also inhibits certain glutamate receptors and voltage gated calcium channels which may lead to its efficacy against migraines.

Topamax is easily absorbed and well tolerated. Children over 2 years of age can use this antiepileptic drug as well as adult populations.

Uses and Dosage

The dose of Topamax prescribed will vary depending on the person and condition being treated. Always read packaging labels carefully and follow your doctor’s instructions.

  • Swallow tablet whole
  • Take with or without food
  • For tonic-clonic seizures, adults usually take 400mg divided daily
  • For partial onset seizures, most take 200 to 400mg daily
  • For migraine prevention, adults should take 25 to 50mg daily or as prescribed
  • Do not double dose
  • Drink plenty of fluids to prevent dehydration, kidney stones, or an electrolyte imbalance
  • Do not suddenly stop taking Topamax
  • Contact your doctor if seizures worsen or become more frequent
  • Store at room temperature away from moisture, light, and high heat

Side Effects

Topamax may cause some side effects while it inhibits receptors to prevent seizures and migraines. Speak with your doctor for more information regarding symptoms you may encounter when taking topiramate.

Common Topamax side effects:

  • Dizziness, drowsiness, tiredness
  • Slowed reactions
  • Problems with speech or memory
  • Abnormal vision
  • Numbness or tingling in your arm and legs
  • Decreased sensation (especially in skin)
  • Changes in taste
  • Anxiety
  • Nausea, diarrhea, stomach pain, loss of appetite
  • Fever, weight loss
  • Cold symptoms (stuffy nose, sneezing, sore throat)

Serious Side Effects

Some more serious side effects may occur when taking Topamax. Stop taking this antiepileptic medication and call your doctor immediately if you develop any of the following symptoms:

  • Skin rash
  • Dizziness, loss of coordination
  • Vision problems, blurred vision, eye pain or redness
  • Sudden vision loss
  • Confusions, thinking or memory problems, trouble concentrating
  • Difficulties with speech
  • Dehydration (decreased sweating, high fever, hot and dry skin)
  • Kidney stone (severe pain in your side or lower back, painful or difficult urination)
  • Too much acid in your blood (irregular heartbeats, tiredness, loss of appetite, trouble thinking, shortness of breath)
  • Too much ammonia in your blood (vomiting, unexplained weakness, feeling like you might pass out)

Allergic Reactions

Do not use Topamax if you are allergic to topiramate. If you notice signs of an allergic reaction, stop taking this anticonvulsant and call your doctor.

Topamax allergy symptoms may include:

  • Hives
  • Difficulty breathing
  • Swelling in your face or throat
  • Fever
  • Sore throat
  • Burning eyes
  • Skin pain, red or purple rash
  • Blistering and peeling skin


Do not drink alcohol while taking Topamax because they can interact and cause dangerous side effects or an increase in seizures.

Avoid following a ketogenic diet (high in fat, low in carbohydrates) while taking Topamax.

Topamax may lead to vision problems which can become permanent if not treated quickly. Call your doctor immediately if you experience a sudden decrease in vision. You should also avoid driving or performing hazardous activities until you know how the medication affects you.

This medication may cause an increase in body temperature with a decrease in sweating which can lead to dehydration. Tell your doctor fi you are sweating less and have a high fever with hot, dry skin.

Some people have suicidal thoughts while taking seizure medicine. Monitor changes in your mood or symptoms and report them to your doctor.

Do not suddenly stop taking Topamax or you may experience an increase in seizures.

To ensure the safety of taking this medication, tell your doctor if you have diarrhea or if you have ever had any of the following:

  • Glaucoma or other eye problems
  • Metabolic acidosis
  • Kidney disease, kidney stones, dialysis
  • Lung disease, breathing problems
  • Mood problems, depression, suicidal thoughts or actions
  • Liver disease
  • Growth disorder
  • Soft or brittle bones

Topiramate may increase acid levels in your blood which can weaken bones, cause kidney stones, or lead to growth problems in children. You may need regular blood tests while taking Topamax to ensure you do not have metabolic acidosis, especially if you are pregnant because this can harm an unborn baby.

Topamax can make you drowsy and taking it with other drugs that also cause drowsiness can worsen the effect. Consult with your doctor before using opioid medication, a sleeping pill, muscle relaxer, or medicine for anxiety or depression.

Some medications can interact with topiramate and cause adverse reactions. Tell your doctor about all the medications you take, even over the counter medicine, vitamins, herbal products, but especially the following:

  • Zonisamide
  • Birth control pills
  • Divalproex, valproic acid
  • Glaucoma medications, including eye drops

Taking Topamax while pregnant may increase the risk of cleft lip or cleft palate in your baby, even in early pregnancy before you may know that you are pregnant. Consult with your doctor if you become pregnant to outline a treatment plan because having seizures while pregnant can also cause harm.

If you are not pregnant or planning to become so, use effective birth control to prevent pregnancy while using Topamax.

Breastfeeding while taking Topamax may not be safe; consult with your doctor.

Form and Strength

This seizure medication is available in tablet form.

Topamax tablet strengths:

  • 25mg
  • 50mg
  • 100mg
  • 200mg

The 25mg tablets are available in quantities of 60 and 100, the 50mg ones are available in groups of 60 and 120, the 100mg tablets in groups of 60, 100, and 120, and the 200mg tablets are available in quantities of 60 and 100.


When is the best time of day to take Topamax?

When divided into two doses a day, Topamax is usually taken in the morning and evening. At the start of treatment, however, if your dose is increased you may only take it at night for a week before returning to a divided dose. If taken once a day, you may want to take it at night because it can cause drowsiness.

How long can you stay on Topamax for migraines?

You should be able to use Topamax long term to prevent migraine headaches, as long as the medication remains effective and safe. Consult with your doctor to determine how long you should continue the treatment.

Does Topamax cause weight loss?

Yes, topiramate has been shown to cause weight loss in those using it for both seizures and migraines. One of its side effects is loss of appetite which can lead to decreases in weight. This medication is not, however, FDA-approved for weight loss.



Additional information

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Scientific Name:


Other Names:

Topamax, Topaz, Topiramate


25mg, 50mg, 100mg, 200mg

Quantities Available:

60, 90, 100, 120, 180